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Veterinary Acupuncture and Pain Management
Acupuncture for your pet
Species treated:
Dogs, Cats, Rabbits, Horses (other species will be considered on a case by case basis so please contact me to discuss).
It is very easy to be sceptical about acupuncture (I was, until I started researching it) and I have benefitted from the effects myself.
Its usefulness in chronic pain management cannot be underestimated and patients suffering from long-standing painful conditions are often unresponsive to many drugs we use or are unable to tolerate them. For these patients acupuncture can be of real benefit, improving comfort and reducing the reliance on medication. However, acupuncture is usually used alongside additional pain relief to get the best results.
What is acupuncture?
It can only be performed in the UK by a qualified veterinary surgeon who is a practising member of the Royal College of Veterinary Surgeons (MRCVS) and has undergone specific training in acupuncture.
There are 2 approaches to acupuncture:
Traditional Chinese Medicine (TCM), which most people are familiar with, has been practiced by Chinese populations and other Eastern European cultures for thousands of years. The belief is that the body has 2 opposing forces, Yin and Yang, which must be in balance. In disease, there is an imbalance and this leads to a blockage of energy flow round the body (Qi “chee”). Qi flows along energy pathways called meridians of which there are 12 with over 2000 acupuncture points.
The Western approach (my approach) is defined as “A therapeutic modality involving the insertion of needles using knowledge of anatomy, physiology, pathology and evidence-based medicine”. It practices the insertion of needles in to specific points of the body, similar to TCM but has developed scientific explanations for the effects we see.
There are 2 types of needling technique:
- Basic manual acupuncture (Dry Needling)
- Electroacupuncture
Any form of needling should result in a sensation around the needle (De Qi – “Da Chee”. People describe a variety of sensations including warmth, tingling, heaviness or a dull ache but sometimes it can be uncomfortable.
Electroacupuncture (EAP) applies a small current to needle pairs which causes small movements of the needles thereby increasing the “dose” of acupuncture that is delivered. This can be reproduced by manually stimulating the needle with dry needling (quick, short in/out movement of the needle, without removing the needle) but EAP is considered gold standard for stimulation.
How does it work?
In simple terms:
⦁ Local effects at the site of the needle include dilation of blood vessels and therefore increase in blood flow, nerve growth (on a small scale), new blood vessel growth – this can help with wound healing and localised anti-inflammatory effects
⦁ Release of endorphins - Acupuncture encourages the brain and central nervous system to produce more of the body's natural pain killers (e.g. beta–endorphins). This is thought to be the main mechanism by which acupuncture produces pain relief and accounts for the “feel-good” factor described by some people who have had acupuncture.
⦁ Pain inhibition at the level of the spinal cord - Pain sensing nerve fibres (C- fibres) are slow conducting and conduct their signal from the site of pain to the spinal cord. Larger fibres (A-delta) are responsible for transmitting the first sensation of pain and are much faster. These A-delta sensory nerves are activated by the insertion of the acupuncture needle sending a more important message to the brain, thereby over-riding / inhibiting the signal from the slow pain C-fibres. It also acts via the descending inhibitory pain pathway (our own internal system to down regulate pain)
⦁ Trigger Points - Myofascial pain is pain arising from activated trigger points in muscles. These arise where area of damage has occurred. We know them as “tight knots” in our muscles. In many patients suffering from pain, these are formed due to adaptations that an animal makes to the way it stands or moves to compensate for the injury or pain (postural shift). For example dogs may develop myofascial pain along their backs with hind limb problems, it may even extend further forward to involve the front legs, or even the neck with long standing, marked postural shift. Acupuncture is a good method of dispersing and treating these problem areas by placing needles into and around trigger points.
⦁ Segmental acupuncture – this is when we insert needles into muscle groups very close to the spinal cord (paraspinal needling) that are innervated by the same nerves as the internal organs. Where we place the needle depends on the condition / organ we are trying to target. This enables us to treat functional internal problems and also relieve visceral pain.
What conditions can be treated with acupuncture?
Some conditions that may benefit include:
⦁ Musculoskeletal Problems e.g. Osteoarthritis
⦁ Spinal Pain e.g. Spondylosis (arthritis of the spine), Lumbosacral disease, Intervertebral Disc disease
⦁ Muscle / tendon injuries
⦁ Rehabilitation of orthopaedic and neurological conditions
⦁ Some functional conditions (e.g. constipation in cats (usually secondary to megacolon), gut stasis in rabbits, irritable bowel type issues, urinary incontinence) -see segmental acupuncture
⦁ Cystitis in cats
⦁ Certain Skin conditions (e.g. lick granulomas)
⦁ Wound healing
⦁ Some allergic conditions (e.g. rhinitis)
⦁ Reduced nausea and appetite stimulation (chronic kidney disease, side - effects of chemotherapy)
Acupuncture has analgesic (pain-relieving) and non-analgesic effects but pain is the most common indication for veterinary acupuncture. Musculoskeletal pain is likely to be the most responsive and examples include: Myofascial pain (arising from trigger points in muscle and are poorly responsive to traditional non-steroidal anti-inflammatory drugs), Osteoarthritis, Disc related pain, Neuropathic (nerve) pain.
In conditions that are non-painful, acupuncture may help to reset the body's normal functioning.
Acupuncture is not a substitute for surgery, where indicated, but can be used as part of a multi-modal approach to pain management alongside the more conventional medications and therapies (e.g. laser, hydrotherapy, physiotherapy)
It can also be used to help wound healing, some skin problems (e.g. lick granulomas) and other non-painful / functional conditions.
Does it hurt?
Acupuncture needles are extremely fine (much finer than even the smallest needles we use for injections) and stimulate nerves that do not cause the unpleasant feeling of pain that we are trying to treat. Sometimes animals react to the initial insertion of the needles into the skin but most of the time they accept the fine needles very well and often become relaxed and sleepy during the treatment.
The 3 needles on the left of the picture are the needles typically used by small animal vets to give injections, with the green one being the thickest and the orange one being the finest (we use this one for puppies, kittens and smaller pets).
The 2 needles on the right are examples of the solid acupuncture needles with the purple being the thickest and the red being the finest. As you can see even the thickest acupuncture needle is considerably finer that the finest injection needle.
A feline patient receiving acupuncture following surgery to repair a fractured pelvis sustained in a road traffic accident. There was also some damage to the sciatic nerve. These pictures clearly demonstrate how relaxed our patients can be during the procedure. (No sedation has been given – this girl is asleep!)
How often would my pet need treatment?
This really depends on the condition being treated. More acute conditions may benefit from more frequent treatments but the usual course for chronic pain is once a week for 4-6 weeks. After 4 weeks we will know whether acupuncture is working for your pet and then, depending on the condition and how well they responded, we can work out a plan that usually involves tailing off the treatment so the effect is maintained for as long as possible. Some animals never need treating again, others may require infrequent “top-ups” treatments and some will need regular sessions to keep the clinical signs at bay. Usually it is the owner that picks up on changes in their pets behaviour and schedules the next appointment when necessary.
Is acupuncture safe?
Acupuncture is very safe in the right hands. There have been no official reports of problems in animals, but there are some in humans and these can be avoided with care and a good knowledge of anatomy. There are a very few cases in which we would have to be very cautious about using acupuncture, but your veterinary acupuncturist can advise you of these.
What can I expect during treatment?
Your first visit will be around 60 minutes (for full pain assessment) or 30-45 minutes (for acupuncture only), which will allow time to take a full clinical history and perform an appropriate examination prior to performing acupuncture. Needles will be inserted into various parts of the body according to the condition that is being treated. There is no “set” dose of acupuncture as there is for medication, so the veterinary acupuncturist will judge how much to do based on your pets response both at the time and after the treatment.
Follow up visits will include a re-examination and further acupuncture treatment tailored to your pets response to the previous dose and will usually be 30 minutes.
What can I expect after treatment?
It is not uncommon for pets to go home and sleep very soundly for a long time. This is a good sign and indicates that your pet will probably respond well to acupuncture. Do not worry if they are not sleepy – this does not mean they will not respond. Sometimes your pet may seem a little more euphoric than usual, again this is a good sign but keep them quiet for the rest of the day or they may overdo things.
Otherwise treat your pet normally after acupuncture.
What about response?
Not all animals respond to acupuncture, 10-20% are classed as “non-responders”, but this cannot be determined other than by treating. Of those animals that do respond, some are very sensitive to treatment and need brief, light needling to achieve a good response, whilst others need stronger stimulation, including electrical stimulation of the needles (electroacupuncture) to achieve a satisfactory or long-lasting response. An animal cannot be classed as a true non-responder until electroacupuncture has been tried. Your vet will advise when they feel it is appropriate to use electroacupuncture.
Your pet may show one of 3 responses to treatment:
1. You may see an improvement. This may occur any time in the 3 days after treatment. The signs that we are trying to treat may then return before the next treatment, but this is fine. After each subsequent treatment the effects should be better and last longer, until a plateau is reached. After this the treatment frequency is altered to maintain this plateau.
2. You may see no response. This is always disappointing but does not mean your pet will not respond; it may just be that they will take a little longer or that their improvement after the last visit but too small or brief for you to see. We cannot say that they will not respond until after the 4th treatment. Not all humans or animals are responders, but about 80% will be.
3. They may seem a little stiffer or more uncomfortable. This means that the dose was a bit too much, but also shows that they should respond to treatment. After a day or two they will improve again and should be better than before. Your vet will then make adjustments to the dose for next time.
Is acupuncture covered by Pet Insurance?
Many Pet Insurers will cover the cost of acupuncture under complimentary therapy. You should check with your policy provider if this is covered under your policy and if so what the cover limit is. If you pet is also receiving hydrotherapy then this could also be included under complimentary therapy so you might exceed your claim limit.
Unfortunately I will not be able to do direct claims with your insurance company but will be happy to complete the necessary part on your insurance form for you to submit.
What about medication that my pet is on?
Withdrawal of concurrent medication is not necessary and is usually not advised but this is something that I will discuss with you at the time of your pets treatment.
Further Information
If you would like any further information regarding acupuncture or your pets suitability for this treatment then please contact me via the online enquiry form or email me at vetacupuncturelincs@gmail.com.
If you would like a vet referral then please complete the online referral form.